Timeliness in breast cancer treatment—the sooner, the better
Menées à partir des données des registres américains des cancers incluant des patientes atteintes d'un cancer du sein, ces deux études évaluent les effets du délai entre le diagnostic et le début de la chimiothérapie adjuvante (pour l'une) ou des traitements (pour l'autre) sur la survie des patientes en fonction du sous-type de la maladie
Defining the impact of delays in breast cancer care is a difficult task. Although the question—“when should I undergo treatment?”—is simple, necessary, and asked by patients every day, our understanding of its therapeutic implications is incomplete. Prospective trials comparing longer vs shorter pretreatment intervals would not be ethically acceptable to patients or clinicians, and will not be performed. Therefore, we rely on retrospective and observational data. Numerous factors confound analysis of the correlation between treatment delay and survival outcomes, and many of these (including level of comorbidity, treatment compliance, social support, and access to health care) are impossible to capture fully even with highly granular data sets and sophisticated statistical models. However, despite the inherent pitfalls of retrospective analyses, the articles by Bleicher et al1 and Chavez-MacGregor et al2 in this issue of JAMA Oncology are an important step toward defining the risks of delay.
JAMA Oncology , éditorial, 2014